Comparative analysis of hematological parameters and protein markers in human papillomavirus-positive versus -negative oropharyngeal cancers.
Purpose/Objective
HPV-positive cancer is strongly immunogenic tumor which induces cell type response in surrounding microenvironment. Systemic inflammation is generally accompanied by cancer disease and it weakens cell response and negatively influences organism reaction to cancer
The aim of present study was to compare laboratory parameters of the immune system: leukocyte count (WBC), neutrophil count (Neut) and lymphocyte count (Lym), monocyte count (Mono), C-reactive protein (CRP), Interleukine 6 (Il-6), in patients with HPV-positive and HPV-negative OPC.
Material/Methods
75 patients were treated with curative intent with radiotherapy alone (32 %) or combined with platinum-based chemotherapy (68%). There were 47% patients with T1/2 and 53% with T3/4 of primary tumor stage and 44% and 56% of patients with N0 and N+ nodal stage disease, respectively. Complete blood counts (CBC), C-reactive protein (CRP) and Il-6 were estimated in blood or serum before and after the treatment. HPV DNA was determined in plasma by QPCR method.
Results
In patients with HPV-negative OPC WBC count (p=0,006 median: 6,88 vs 5,69), Lym count (p=0,02 median: 1,96 vs 1,49) and CRP (p=0,0001 median: 5,88 vs 1,35 mg/dl ) was higher than for HPV-positive OPC before treatment. Additionally, in patients with HPV-negative OPC WBC count (p=0,03 median: 5,53 vs 4,17), Lym count (p=0,02 median: 0,69 vs 0,44), Mono count (p=0,003 median: 0,58 vs 0,43) and Il-6 (p=0,05 median: 25,53 vs 11,65 pg/ml) was higher than for HPV-positive OPC after therapy. Before treatment significantly longer overall survival (OS) for patients with low WBC count (p=0,001)(Fig.1), low concentration of CRP (p=0,0001) (Fig. 2) and Il-6 (p=0,01) was also found.
Conclusion
Inflammation processes are more severe in HPV-negative OPC. Low levels of inflammatory indicators like WBC count, Lym count, CRP, Il-6 may be associated with longer OS in this group of patients. Systemic inflammation reflects host reaction on cancer, characterized by a significant weakness of cellular immunity. It is more characteristic for patients with HPV–negative OPC
